Abstract
BackgroundTo analyze the clinical features of brain tumor-related epilepsy (BTRE) and explore the factors influencing the identification of epilepsy-associated tumor (EAT), in order to advance the clinical understanding of BTRE and EAT.MethodsIntracranial tumor origin and location as well as the type of epilepsy were retrospectively reviewed in 153 BTRE patients. The patients were further divided into the EAT and non-EAT groups, and comparisons were made for age, sex, tumor origin and location, and epilepsy type between the two groups.ResultsThe 153 BTRE patients were divided into 78 cases with primary intracranial tumor and 75 cases with tumor originating from extracranial metastasis, according to the origin of tumor. According to the location of tumor, 116 cases had tumor lesions located in the brain parenchyma, and 37 cases had tumor lesions located in the meninges. Further, in the group with a brain parenchyma location, 77 cases had single lobular involvement, and 39 cases had multiple-lobular involvement; 84 cases had tumor lesions located in one hemisphere and 32 cases in both hemispheres. According to the type of epilepsy, 92 cases had generalized seizures, and 61 cases had focal seizures. The type of epilepsy did not significantly correlate with the origin of intracranial tumor, the location of tumor lesions (in brain parenchyma or meninges) (P > 0.05), or the hemispherical location (in one or two hemispheres) of lesions (P > 0.05), but was significantly related with the lobular localization of lesions (P < 0.05). The 153 cases of BTRE consisted of 87 EAT and 66 non-EAT, with significant differences in the origin, location and type (being glioma/non-glioma) of tumor. Logistic regression analysis showed that the type of tumor (i.e. whether being glioma) served as an independent factor for EAT identification; the lower the World Health Organization grade of glioma, the more likely the EAT is to be diagnosed (P < 0.05).ConclusionThe majority of BTRE patients in this study had tumors located in the brain parenchyma. In addition, the patients with generalized seizures outnumbered those with focal seizures, and the type of epilepsy was correlated with the lobular location of tumor lesions. The EATs are mostly low-grade gliomas.
Highlights
To analyze the clinical features of brain tumor-related epilepsy (BTRE) and explore the factors influencing the identification of epilepsy-associated tumor (EAT), in order to advance the clinical understanding of BTRE and EAT
Participants One hundred and fifty-three BTRE patients (85 males and 68 females, age range 3–88 years, average 48.67 ± 16.58 years) who were diagnosed and treated in Mianyang Central Hospital of Sichuan Province from January 2010 to December 2017 were employed in this study, based on the following inclusion criteria: (1) diagnosed with epilepsy according to the definitions proposed by the International League Against Epilepsy in 2005[5]; (2) brain imaging (MRI or computed tomography (CT)) suggesting intracranial tumor; and (3) histopathological evaluation of biopsy confirming the diagnosis of tumor
The 153 participants were divided into EAT and non-EAT groups according to whether epilepsy is the primary and main symptom, and the two groups were compared for seizure type, tumor origin, and tumor location to determine the independent factors for EAT identification
Summary
To analyze the clinical features of brain tumor-related epilepsy (BTRE) and explore the factors influencing the identification of epilepsy-associated tumor (EAT), in order to advance the clinical understanding of BTRE and EAT. About 25–60% of patients with intracranial tumor may develop symptoms of epilepsy. EAT with a history of drug-resistant seizures for over 2 years is called long-term epilepsy-associated tumor (LEAT)[4]. We set out to retrospectively review the origin and location of intracranial tumor, the type of seizure, and the classification of tumor-related epilepsy in 153 patients with BTRE, analyze the clinical characteristics of BTRE, and determine the independent factors that influence EAT identification, in order to provide theoretical guidance for clinical management of BTRE and facilitate early detection and treatment of EAT
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